scholarly journals Therapeutic interventions in primary care, youth mental health settings for young people with Borderline Personality Disorder or borderline traits

2020 ◽  
Author(s):  
Nikki O’Dwyer ◽  
Debra Rickwood ◽  
Dean Buckmaster ◽  
Clare Watsford
Keyword(s):  
Mental Health ◽  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Young People ◽  
Youth Mental Health ◽  
Borderline Personality ◽  
Therapeutic Interventions ◽  
Evidence Based ◽  
Data Set ◽  
Evidence Based Guidelines

Abstract Background This study aimed to investigate what therapeutic interventions are currently being applied by clinicians working with young people who have a diagnosis of Borderline Personality Disorder or borderline traits. Given the current lack of evidence-based guidelines with this client population, investigating what is occurring currently is needed. The study also aimed to determine whether the interventions clinicians are using are effective in reducing distress and increasing functioning with these clients. Methods Participant data came from the national minimum data set for headspace youth mental health centres across Australia. Young people’s data were included in the study if the young person was diagnosed with Borderline Personality Disorder or borderline traits during their first episode of care (N=701). Clinician data that indicated the sort of intervention used at each client session and outcome measures routinely captured were analysed to determine interventions used and outcomes achieved. Results Results demonstrated that CBT was the most frequently used modality of intervention followed by supportive counselling and IPT. There were no or only weak relationships between changes in outcomes and the amount of any type of intervention that was provided. No significant relationship was found with the amount of CBT a client received and changes in symptoms or functioning, despite being the most commonly employed modality. Conclusions The study highlights the need for evidence-based guidelines for early intervention in young people with borderline personality disorder.

scholarly journals Therapeutic interventions in Australian primary care, youth mental health settings for young people with Borderline Personality Disorder or borderline traits

2020 ◽  
Author(s):  
Nikki O’Dwyer ◽  
Debra Rickwood ◽  
Dean Buckmaster ◽  
Clare Watsford
Keyword(s):  
Mental Health ◽  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Young People ◽  
Youth Mental Health ◽  
Borderline Personality ◽  
Therapeutic Interventions ◽  
First Episode ◽  
Evidence Based ◽  
Data Set

Abstract Background This study aimed to investigate what therapeutic interventions were being applied by clinicians working with young people with a diagnosis of Borderline Personality Disorder or borderline traits in Australian primary mental health care settings. Given the current lack of evidence-based guidelines for treatment with this client population, investigating what is being implemented is needed. The study also aimed to determine whether the interventions clinicians are using are effective in reducing distress and increasing functioning for these clients. Methods Participant data came from the national minimum data set for headspace youth mental health centers across Australia. Young people’s data were included in the study if the young person was diagnosed with Borderline Personality Disorder or borderline traits during their first episode of care (N=701). Clinician data that indicated the type of intervention used at each client session and outcome measures routinely captured were analyzed to determine interventions used and outcomes achieved. Results Results demonstrated that CBT was the most frequently used modality of intervention followed by supportive counselling and IPT, but that most clients received a variety of intervention types. There were no or only weak relationships between changes in outcomes and the amount of any type of intervention that was provided. No significant relationship was found with the amount of CBT a client received and changes in symptoms or functioning, despite being the most commonly employed modality. Conclusions The study highlights the need for evidence-based treatment guidelines for early intervention in young people with borderline personality disorder traits.

scholarly journals Therapeutic interventions in Australian primary care, youth mental health settings for young people with borderline personality disorder or borderline traits

2020 ◽  
Vol 7 (1) ◽  
Author(s):  
Nikki O’Dwyer ◽  
Debra Rickwood ◽  
Dean Buckmaster ◽  
Clare Watsford
Keyword(s):  
Mental Health ◽  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Young People ◽  
Youth Mental Health ◽  
Borderline Personality ◽  
Therapeutic Interventions ◽  
First Episode ◽  
Evidence Based ◽  
Data Set

Abstract Background This study aimed to investigate what therapeutic interventions were being applied by clinicians working with young people with a diagnosis of Borderline Personality Disorder or borderline traits in Australian primary mental health care settings. Given the current lack of evidence-based guidelines for treatment with this client population, investigating what is being implemented is needed. The study also aimed to determine whether the interventions clinicians are using are effective in reducing distress and increasing functioning for these clients. Methods Participant data came from the national minimum data set for headspace youth mental health centers across Australia. Young people’s data were included in the study if the young person was diagnosed with Borderline Personality Disorder or borderline traits during their first episode of care (N = 701). Clinician data that indicated the type of intervention used at each client session and outcome measures routinely captured were analyzed to determine interventions used and outcomes achieved. Results Results demonstrated that CBT was the most frequently used modality of intervention followed by supportive counselling and IPT, but that most clients received a variety of intervention types. There were no or only weak relationships between changes in outcomes and the amount of any type of intervention that was provided. No significant relationship was found with the amount of CBT a client received and changes in symptoms or functioning, despite being the most commonly employed modality. Conclusions The study highlights the need for evidence-based treatment guidelines for early intervention in young people with borderline personality disorder traits.

Borderline Personality Programme in a Rural Area: The Value of a Therapy

2017 ◽  
Vol 41 (S1) ◽  
pp. S714-S714
Author(s):  
M. Marin Olalla ◽  
B. Perez Ramirez ◽  
A.M. Vidal Lopez ◽  
B. Martinez Martinez ◽  
R. Maldonado Lozano
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Functional Organization ◽  
Borderline Personality ◽  
Therapeutic Interventions ◽  
Therapeutic Group ◽  
Behaviour Therapy

IntroductionAn increased incidence of personality disorders (TP) in general, and borderline personality (BP) is currently a significant health problem because of the complexity of the clinic, the difficulty for early diagnosis, often unsatisfactory response to available treatments and the lack of clear proposals on multidisciplinary therapeutic interventions. In more serious cases, people with TP generate a high level of self and family suffering, as well as a high care burden that does not have a proportional impact on the quality of life of those affected and their families.AimEstablish a stable functional organization of professional and organizational resources of the Mental Health Unit of the North of Almeria that ensuring comprehensive care for people with borderline personality disorder and their families.MethodsThe program was structured:– elemental: BP census, individual sessions with optional nurse reference;– advanced individual: BP census, individual sessions, Nurse reference;– advanced individual and group: BP census, Individual sessions, Nurse reference and Therapeutic Group Hospital Mental Health Day weekly applying dialectical behaviour therapy.ResultsThe census of patients with borderline personality disorder was established in 30 people, 20 of them participating in two editions of therapeutic group. Fifty weekly sessions were carried out continuously, except holiday periods. A multidisciplinary team (nurse and two psychiatrists) were involved. The results indicate that there was an improvement in the quality of life of patients. It had been reduced hospitalisations, emergency assistance, and more than 60% of them got a job after that.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Ten-week Intensive Group Program (IGP) for borderline personality disorder: making the case for more accessible and affordable psychotherapy

2021 ◽  
pp. ebmental-2020-300195
Author(s):  
Dervila Gec ◽  
Jillian Helen Broadbear ◽  
David Bourton ◽  
Sathya Rao
Keyword(s):  
Mental Health ◽  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Symptom Severity ◽  
Integrated Treatment ◽  
Borderline Personality ◽  
Self Report ◽  
Evidence Based ◽  
Short Term ◽  
Intensive Group

BackgroundThe availability of specialist psychotherapies for treating borderline personality disorder (BPD) is limited by costs associated with training, resourcing and treatment duration. Developing a programme that incorporates effective strategies from a range of evidence-based specialist treatments, concentrates their delivery and uses a group-based format will improve treatment access.ObjectiveTo assess the short-term clinical efficacy, acceptability and feasibility of a bespoke manualised programme for the treatment of BPD. This 10-week group-based outpatient programme was delivered 2 days per week in 4 hour sessions; participants received 80 hours of treatment in total.MethodsForty-three participants, many having severe BPD symptomatology, were assessed before and after the 10-week programme using a range of validated self-report questionnaires and a self-appraisal feedback form. The primary outcome measured was BPD symptom severity.FindingsStatistically significant improvements were measured in BPD symptom severity, depression, trait anxiety, emotional regulation, general health, hopefulness, self-compassion and anger, several with moderate to large effect sizes. Many of these improvements remained at 4–6 months post treatment. More than 90% of surveyed participants expressed a moderate or high level of satisfaction with the programme.ConclusionsThis integrated treatment programme delivered in a highly concentrated format demonstrated short-term efficacy across many BPD-relevant endpoints; its acceptability was endorsed by most clients.Clinical implicationsIncorporation of key aspects of evidence-based treatment using a time-intensive group format could greatly enhance the capacity of mental health services to meet the needs of people who experience BPD within a population-based mental health service framework.

Emotion-Oriented Coping Style Predicts Self-Harm in Response to Acute Psychiatric Hospitalization

Crisis ◽  
2020 ◽  
pp. 1-7
Author(s):  
Jacqueline M. Frei ◽  
Vladimir Sazhin ◽  
Melissa Fick ◽  
Keong Yap
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Psychiatric Hospitalization ◽  
Coping Styles ◽  
Psychiatric Inpatients ◽  
Borderline Personality ◽  
Self Report ◽  
Therapeutic Interventions ◽  
Coping Behaviors ◽  
Self Harm

Abstract. Psychiatric hospitalization can cause significant distress for patients. Research has shown that to cope with the stress, patients sometimes resort to self-harm. Given the paucity of research on self-harm among psychiatric inpatients, a better understanding of transdiagnostic processes as predictors of self-harm during psychiatric hospitalization is needed. The current study examined whether coping styles predicted self-harm after controlling for commonly associated factors, such as age, gender, and borderline personality disorder. Participants were 72 patients (mean age = 39.32 years, SD = 12.29, 64% male) admitted for inpatient treatment at a public psychiatric hospital in Sydney, Australia. Participants completed self-report measures of coping styles and ward-specific coping behaviors, including self-harm, in relation to coping with the stress of acute hospitalization. Results showed that younger age, diagnosis of borderline personality disorder, and higher emotion-oriented coping were associated with self-harm. After controlling for age and borderline personality disorder, higher levels of emotion-oriented coping were found to be a significant predictor of self-harm. Findings were partially consistent with hypotheses; emotion-oriented but not avoidance-oriented coping significantly predicted self-harm. This finding may help to identify and provide psychiatric inpatients who are at risk of self-harm with appropriate therapeutic interventions.

Rumination in Borderline Personality Disorder: Meta-Analysis

2018 ◽  
Author(s):  
Mara J. Richman ◽  
Zsolt Unoka ◽  
Robert Dudas ◽  
Zsolt Demetrovics
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Emotion Dysregulation ◽  
Meta Analysis ◽  
Borderline Personality ◽  
Therapeutic Interventions ◽  
Sample Type ◽  
Moderator Variables ◽  
Analytic Review ◽  
Self Harm

Borderline personality disorder (BPD) is characterized by deficits in emotion regulation and affective liability. Of this domain, ruminative behaviors have been considered a core feature of emotion dysregulation difficulties. Despite this, inconsistencies have existed in the literature regarding which rumination type is most prominent in those with BPD symptoms. Moreover, no meta-analytic review has been performed to date on rumination in BPD. Taking this into consideration, a meta-analysis was performed to assess how BPD symptoms correlate with rumination, while also considering clinical moderator variables (i.e., BPD symptom domain, co-morbidities, GAF score) and demographic moderator variables (i.e., age, gender, sample type, and education level). Analysis of correlation across rumination domains for the entire sample revealed a medium overall correlation between BPD symptoms and rumination. When assessing types of rumination, the largest correlation was among pain rumination followed by anger, depressive, and anxious rumination. Among BPD symptom domain, affective instability had the strongest correlation with increased rumination, followed by unstable relationships, identity disturbance, and self-harm/ impulsivity, respectively. Demographic variables showed no significance. Clinical implications are considered and further therapeutic interventions are discussed in the context of rumination.

Primary care and suicidality among psychiatric outpatients: The patient-doctor relationship matters

2020 ◽  
pp. 009121742097799
Author(s):  
Krista Schultz ◽  
Sharan Sandhu ◽  
David Kealy
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Primary Care Physician ◽  
Population Based ◽  
Borderline Personality ◽  
Care Physician ◽  
Cross Sectional

Objective The purpose of the current study is to examine the relationship between the quality of the Patient-Doctor Relationship and suicidality among patients seeking mental health care; specifically, whether patients who perceive having a more positive relationship with primary care physician will have lower levels of suicidality. Method Cross-sectional population-based study in Greater Vancouver, Canada. One-hundred ninety-seven participants were recruited from three Mental Health Clinics who reported having a primary care physician. Participants completed a survey containing questions regarding items assessing quality of Patient-Doctor Relationship, general psychiatric distress (K10), borderline personality disorder, and suicidality (Suicidal Behaviours Questionnaire-Revised-SBQ-R). Zero-order correlations were computed to evaluate relationships between study variables. Hierarchical regression analysis was used to control for confounding variables. Results The quality of the patient doctor relationship was significantly negatively associated with suicidality. The association between the quality of the patient-doctor relationship and suicidality remained significant even after controlling for the effects of psychiatric symptom distress and borderline personality disorder features. Conclusions The degree to which patients’ perceive their primary care physician as understanding, reliable, and dedicated, is associated with a reduction in suicidal behaviors. Further research is needed to better explicate the mechanisms of this relationship over time.

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